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Drug Interactions between atazanavir and didanosine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

didanosine atazanavir

Applies to: didanosine and atazanavir

ADJUST DOSING INTERVAL: Concurrent administration of didanosine buffered tablets or powder or the pediatric oral solution may significantly decrease the oral bioavailability of atazanavir. Atazanavir solubility decreases with increasing pH, thus buffering agents in the didanosine formulations may interfere with dissolution of the drug. In 32 study subjects, simultaneous administration of didanosine buffered tablets (200 mg single dose) and stavudine (40 mg single dose) reduced the plasma concentrations of atazanavir (400 mg single dose) by over 80% compared to administration of atazanavir alone. The interaction was not observed when atazanavir was administered one hour after didanosine and stavudine. Atazanavir also had no significant effects on the pharmacokinetics of didanosine or stavudine during concurrent administration.

MANAGEMENT: Atazanavir should be administered, with food, 2 hours before or 1 hour after didanosine buffered formulations. Didanosine delayed-release capsules are not buffered and are not expected to cause this interaction. However, because didanosine should be administered on an empty stomach, the capsules should also be administered at different times from atazanavir.

References (2)
  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb
  2. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

didanosine food

Applies to: didanosine

ADJUST DOSING INTERVAL: Didanosine bioavailability is decreased when administered with food. Loss of efficacy may result.

MANAGEMENT: Didanosine should be administered in the fasting state, at least 30 minutes before or more than 2 hours after eating.

References (1)
  1. (2002) "Product Information. Videx (didanosine)." Bristol-Myers Squibb
Moderate

atazanavir food

Applies to: atazanavir

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.

References (1)
  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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